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TL Respiratory

Respiratory A&P review (LAG)

gas exchange, Delivery of O2 to tissues, Removal of CO2, synthesis of surfactant and other chemicals, metabolism and detoxification of drugs and toxins, defense against infection

What are the major organs housed in the thorax?

Lungs, mediastinum – heart and major vessels

What’s unique to the first 7 ribs?

true ribs – attached to sternum and vertebral column

How do ribs 8-10 attach?

to the rib above

How do ribs 11&12 attach?

only at the vertebra, no anterior attachment

What is the name of the spaces between ribs?

intercostals spaces

What is the name of the angle between the xyphoid process of the sternum and the costal cartilages?

Costal angle

What muscle is the major muscle of respiration?

the diaphragm

What does contraction of the diaphragm do?

Contraction of the diaphragm promotes inhalation by flattening the dome shaped muscle downward toward the abdomen causing expansion in the lungs thus a decrease in pressure resulting the rushing in of air

The two layers of serous membrane surrounding the lungs- visceral pleura and parietal pleura and 5-15mL of fluid to facilitate smooth movement between the layers

Name the 3 sections of the pharynx.

nasopharynx, oropharynx, laryngopharynx (or hypopharynx)

Name two structures located in the nasopharynx.

adenoids and openings to Eustachian tubes

Name two structures in the laryngopharynx.

epiglottis and larynx (voice box)

Describe the cartilage of the trachea.

16-20 C shaped with open side to back

About where do the right and left bronchi divide?

about the second or third intercostals space

What is the cartilage called where the left and right bronchi devide?

carina

Define the area included in the term airway.

from the nose to the terminal bronchioles

What structures make up the upper airway?

nasal cavity, sinuses, mouth, pharynx, and larynx

Describe the components of atmospheric air.

21% Oxygen, 78% nitrogen, some other stuff

List the primary functions of the nasal cavity.

warm/cool, filter, humidify inspired air

Why is aspirated fluid more likely to go in the right lung? Why is it that ETT displacement more commonly happens in the right bronchus?

the right bronchus is shorter, wider, less bent – straight angle off main bronchus

Name the descending parts of the tracheobronchial tree.

trachea, main stem bronchi to lobar branches to segmental bronchi to subsegmental bronchi to bronchioles to terminal airways

What are airways less than 2mm in diameter?

bronchioles

Define anatomical deadspace.

normal passages for air (airways) where no gas exchange takes place – nose to conducting airways

Define alveolar deadspace.

Areas in aveoli where gas exchange does not occur

Define physiologic deadspace.

alveolar dead space + anatomical dead space

Define mucociliary escalator.

specialized mucous membrane lining the lower respiratory tract; composed of pseudostratified columnar epithelium; lined with cilia that work like an escalator to carry mucous trapped debris to the pharynx for expectoration or swallowing

Name several substances that inhibit/paralyze the cilia of the lower respiratory tract.

smoke, pollutants, alcohol, anesthesia, high O2, dehydration

What structure of the respiratory tract marks the transition to the respiratory zone?

The pressure gas exerts is inversely related to volume so that when volume goes up (as in expanding thoracic cavity) pressure goes down; When volume goes down (such as in smaller area in the thoracic cavity during expiration) pressure goes up

How many mmHg is atmospheric pressure?

760 mmHg

Discuss the relationship of atmospheric pressure to intrathoracic/intraplueral pressure.

Alveolar pressure of O2 is about 100mmHg, Venous pressure is about 40mmHg

Define ventilation/perfusion matching.

ventilation is the air being carried to the aveoli and perfusion adequate flow of blood to pick up oxygen; matching means That the amount of oxygen delivered is the amount that the body needs and the blood is able to pick it up and deliver it.

What happens if we have ventilation but lack perfusion?

No gas exchange

What is dead space?

where no gas exchange takes place

Give some examples of condition that increase the amount of dead space.

Emphysema and pulmonary embolism

Give some examples of conditions in which the blood flow to the aveoli is adequate but ventilation is inadequate.

pneumonia, atelectasis, ARDs

Give 2 ways that O2 is delivered by the blood.

3% is dissolved and 97% is bound to Hgb

What does pulse oximetry tell us about?

O2 bound to Hgb

How is CO2 carried in the blood?

70% in bicarbonate, 20% in doxygenated Hgb- carbaminohemoglobin, 10% dissolved – this value is what PCO2 measures in ABGs

What percentage of energy is used by a healthy person for breathing at rest? With exercise?

What are some potential causes of depression of the respiratory center (medulla)? (O A H C)

O.D., anesthesia, Head trauma, CVA

Give some examples of conditions that would interfere with impulse transmission from the respiratory center to the muscles of respiration.

Lesion at the cervical level of the spinal cord; nerve or neuromuscular disorders like polio, Guillain-Barre, Myasthenia Gravis

Define Guillain-Barre.

serious disorder that occurs when the body's defense (immune) system mistakenly attacks part of the nervous system. This leads to nerve inflammation that causes muscle weakness; often starts with a minor infection like a lung/GI infection.

Define Myasthenia Gravis.

chronic progressive disease characterized by chronic fatigue and muscular weakness (especially in the face and neck); caused by a deficiency of acetylcholine at the neuromuscular junctions.

Give some examples of mechanical abnormalities of the chest wall or lung.

Pleural effusion, pneumothorax, hemothorax, flail chest

What are some causes of oxygenation failure?

ventilation perfusion mismatch

Name some conditions that would lead to ventilation/perfusion mismatch.